An administrator's "to-do" list when running an ambulatory surgery center is never-ending. Between ensuring high levels of patient, physician and staff satisfaction as well as keeping tabs on inventory and quality metrics, an administrator has to be, above all, a master juggler. Effective time management, organization and efficiency are skills that administrators need to pick up and hone quickly.
"Productivity and time management are key," says Angie Blankinship, RN, BSN, CASC, administrator of Northstar Healthcare Surgery Center in Dallas. "My days are driven with the immediate situations of the day. Each and every day is different."
Here are some of the most important metrics:
Daily and weekly
1. Cases scheduled vs. cases performed. One of the most important metrics that administrators need to track on a daily and weekly basis is the number of anticipated cases and the number of cases actually performed, according to Vivek Taparia, director of operations at Regent Surgical Health.
2. Staffing ratio. Ms. Blankinship says it is essential administrators check staffing for cases performed every day and week. "Flex staff if needed," she adds.
3. Cash collections. "You need to know what your break-even is for cash collections," says Mr. Taparia. "It is important to check and see if you are hitting those metrics from a break-even standpoint."
4. Regulations. Check regularly to make sure the day-to-day functioning of the center is within the bounds of state and federal regulations, according to Ms. Blankinship.
5. Inventory levels. When ordering supplies, review the schedule for each day and week, and then order the appropriate amount. "Look at par levels," adds Mr. Taparia. "Make sure they aren't too high or too low. Always stay on top of your supply cost."
6. Billing. Staying on top of billing another important daily/weekly task for an administrator. "Administrators need to ask if billing for surgeries is being completed on time and if billing appeals are being performed as they arrive," says Ms. Blankinship.
Monthly
1. Quality metrics. An ASC's value is tied to the quality of care it provides. Keep an eye on key quality metrics on a monthly basis. "Track infection rates, timeouts, hand hygiene adherence, turnover times, cancellations, no-shows, transfer rates," says Mr. Taparia. "These are all important metrics at the quality level."
2. Number of worked hours. According to Scott Edwards, administrator at North MS Ambulatory Surgery Center in Tupelo, Miss., another important metric is the number of worked hours per case. This includes staff, nurse, administrative and clinical hours per case. "This is one of the main indicators I look at monthly," says Mr. Edwards. "It is also helpful if administrators track this metric quarterly and semi-annually."
3. Financial statements. Ensure financial statements are in line with bottom-line profit, says Mr. Edwards.
4. Incidence reports. Keeping track of incidents on a monthly basis is useful for administrators as it allows them to see negative trends and find solutions, according to Ms. Blankinship.
5. Environments of care rounds. Administrators can take rounds to ensure that environmental factors, such as temperature and humidity logs, are recorded at appropriate levels, says Ms. Blankinship. Additionally, administrators need to check if the generator is working properly so it can be used in case of an emergency.
6. Case cost. According to Mr. Taparia, another important monthly metric is case cost. Keep track of how much each case is costing the facility, and this includes cost of implants and other supplies as well as other costs associated with performing each procedure, he says.
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